What does a pathologist do?

A pathologist is a physician specializing in the diagnosis and management of human disease. They may study organs, tissues, fluids of the body, and even the entire body when performing an autopsy. It is a very broad scientific profession. Pathologists work very closely with the entire health care team.

There are many different kinds of pathologists. Clinical pathology deals with the diagnosis of disease via laboratory testing. Forensic pathology focuses on determining cause of death through autopsy and is linked to criminal cases. There are also veterinary pathologists, plant pathologists, experimental pathologists, and molecular pathologists among many other specialties.

A pathologist is a medical doctor that specializes in the study of disease. After medical school they undergo additional training in the study of pathology.They can work in a few different areas like surgical pathology, clinical pathology, or post mortem pathology. An autopsy is a post mortem examination performed by a pathologist to determine the cause of death. They take tissue samples from the body and look at them under the microscope to see if diseases were present. They also investigate suspicious deaths to rule out or rule in foul play. They work closely with law enforcement agencies when investigating these types of cases. A clinical pathologist may work in a hospital and examine tissue samples taken during the course of a surgery.

In medicine, the specialty of pathology is defined as the study of disease. Pathology is the broadest of the medical specialties because it involves study of the effect of all diseases on every part of the human body. To become a pathologist one must first obtain a college degree and then an MD degree. After receiving an MD, the doctor who chooses to become a pathologist must complete a residency in the specialty of pathology, taking three or four years, depending on whether she opts to become an anatomic pathologist, a clinical pathologist, or both (four years for both, three years for either alone).

In pathology residency the doctor must first learn the gross (naked eye) and microscopic (tissue samples on slides viewed with a microscope) appearance of every tissue type in the human body. Only after this is accomplished can the doctor then begin to learn to recognize the effect of diseases on these tissues. When he has mastered this activity, the pathologist becomes able to diagnose disease by examining tissue removed from the body (at surgery or by biopsy), both grossly and under the microscope. The examination of tissues removed from the body is called Surgical Pathology.

Pathologists also perform autopsies, removing and dissecting the organs from deceased patients in order to determine the presence and severity of disease. A subspecialty of autopsy pathology is Forensic Pathology in which autopsies are done for cases involving the legal system for the purpose of determining the cause and circumstances of death. Coroner offices or medical examiners do forensic autopsies, usually when death is unnatural (accident, homicide or suicide).

Another important branch of pathology is Clinical Pathology. This involves studying the effect of diseases on the patient’s blood or other bodily fluids. When a person goes to the medical laboratory to get a blood test, a clinical pathologist medically directs that laboratory.

In addition to the above, there are other subspecialties in pathology such as blood banking pathology, neuropathology, and pediatric pathology.

A Forensic Pathologist spends most of her time doing autopsies. She is occasionally called upon to do death scene evaluations, and must testify in court about her autopsy findings in homicide and wrongful death cases.

The hospital pathologist is usually certified in both anatomic and clinical pathology. He has an office in the hospital and directs the activities of the hospital laboratory. He examines and diagnoses all organs removed from the body during surgery. He attends staff meetings, and acts as a go-between for the treating physicians and the clinical laboratory. He is available to go to the operating room on short notice to perform a frozen section for rapid diagnosis when something unexpected is found during surgery.

In summary, a pathologist is a physician trained in diagnosing disease by examining body tissues and fluids. He does not ordinarily treat patients himself, but assists the clinical doctors in doing so…acting primarily as an expert consultant.

The first reference below is an article from a medico legal web site that I authored years ago on how an attorney should choose a pathologist as an expert witness. It gives a comprehensive explanation of the branches of pathology and the training of pathologists.

The second reference gives the definition of pathology, including all of the many sub-types of pathologist.

Pathologist is a person who studies processes or any condition that limits the power, length, or enjoyment of life. Pathologists use modern instruments and methods, such as electron microscopy, to help them recognize the changes caused by disease in the tissues and organs of the body. They try to explain why a diseased body acts differently from a normal body.

Pathologists use their knowledge of diseased tissues and body fluids to aid treatment. Pathological tests help doctors diagnose a disease and to establish the extent of its attack. These tests may include examination of the blood, urine, and tissues. The use of laboratory tests to diagnose disease is called clinical pathology. Pathologists also study diseased parts removed by surgery. They may examine corpses to learn the exact cause of death.